Table 3.
Subgroup analysis by comorbid conditions, age, education level, and origin of hospitalization: Proportion with elevated initial blood pressure, mean blood pressure, systolic, and diastolic blood pressure by adequate versus low health literacy
| Subgroups | First blood pressure | Mean blood pressure on first hospital day | ||
|---|---|---|---|---|
|
| ||||
| Adequate Health Literacy (BHLS>9) | Low Health Literacy (BHLS ≤9) | Adequate Health Literacy (BHLS>9) | Low Health Literacy (BHLS ≤9) | |
| Diagnosed Hypertension | N=10,519 | N=3,687 | N=10,109 | N=3,562 |
| Blood pressure ≥140/90mmHg* % | 46.6 | 49.0 | 32.5 | 33.1 |
| Unadjusted Odds Ratio (95% CI) † | Reference | 1.10 (1.02, 1.20) | Reference | 1.03 (0.94, 1.12) |
| Adjusted Odds Ratio (95%CI) ‡ | Reference | 1.00 (0.92, 1.09) | Reference | 1.01 (0.93, 1.10) |
| Systolic blood pressure, median (IQR) | 130 (114, 149) | 132 (114, 151) | 126 (114, 139) | 125 (113, 139) |
| Diastolic blood pressure, median (IQR) | 73 (62, 84) | 71 (60, 83) | 70 (63, 79) | 70 (62, 78) |
| No Diagnosis of Hypertension | N=25,180 | N=6,877 | N=24,157 | N=6,583 |
| Blood pressure ≥140/90mmHg* % | 30.9 | 35.1 | 25.3 | 26.3 |
| Unadjusted Odds Ratio (95% CI) † | Reference | 1.21 (1.14, 1.28) | Reference | 1.05 (0.99, 1.12) |
| Adjusted Odds Ratio (95%CI) ‡ | Reference | 1.09 (1.02, 1.16) | Reference | 1.06 (0.99, 1.13) |
| Systolic blood pressure, median (IQR) | 124 (110, 140) | 126 (111, 143) | 125 (113, 138) | 125 (113, 139) |
| Diastolic blood pressure, median (IQR) | 71 (62, 82) | 71 (62, 82) | 70 (62, 78) | 70 (62, 79) |
|
| ||||
| Diabetes or Renal Disease | N =6,426 | N=2,255 | N=6,174 | N=2,174 |
| Blood pressure ≥130/80mmHg, % | 58.1 | 58.5 | 44.2 | 45.5 |
| Unadjusted Odds Ratio (95% CI) † | Reference | 1.01 (0.91, 1.13) | Reference | 1.05 (0.95, 1.16) |
| Adjusted Odds Ratio (95%CI) ‡ | Reference | 0.96 (0.86, 1.07) | Reference | 1.05 (0.94, 1.17) |
| Systolic blood pressure, median (IQR) | 131 (115, 148) | 132 (114, 150) | 125 (113, 139) | 125 (112, 140) |
| Diastolic blood pressure, median (IQR) | 72 (62, 83) | 70 (59, 82) | 70 (62, 79) | 70 (62, 78) |
| No Diabetes or renal disease | N=29,273 | N=8,309 | N=28,092 | N=7,971 |
| Blood pressure ≥140/90mmHg, % | 30.6 | 34.9 | 23.8 | 24.1 |
| Unadjusted Odds Ratio (95% CI) † | Reference | 1.22 (1.15, 1.29) | Reference | 1.02 (0.96, 1.08) |
| Adjusted Odds Ratio (95%CI) ‡ | Reference | 1.07 (1.01, 1.13) | Reference | 1.02 (0.95,1.08) |
| Systolic blood pressure, median (IQR) | 125 (111, 141) | 127 (111, 144) | 125 (113, 138) | 125 (113, 139) |
| Diastolic blood pressure, median (IQR) | 72 (62, 82) | 72 (62, 83) | 70 (62, 78) | 70 (62, 79) |
|
| ||||
| Age 65 years and older | N=9,621 | N=4,515 | N=9,226 | N=4,331 |
| Blood pressure ≥140/90mmHg* % | 40.3 | 45.9 | 28.3 | 29.4 |
| Unadjusted Odds Ratio (95% CI) † | Reference | 1.26 (1.17, 1.36) | Reference | 1.06 (0.97, 1.15) |
| Adjusted Odds Ratio (95%CI) ‡ | Reference | 1.11 (1.03, 1.20) | Reference | 1.02 (0.94, 1.11) |
| Systolic blood pressure, median (IQR) | 130 (112, 147) | 132 (114, 151) | 125 (113, 138) | 125 (113, 139) |
| Diastolic blood pressure, median (IQR) | 68 (58, 78) | 68 (58, 79) | 70 (62, 79) | 70 (62, 79) |
|
| ||||
| Age less than 65 years | N=26,078 | N=6,049 | N=25,040 | N=5,814 |
| Blood pressure ≥140/90mmHg* % | 33.8 | 35.5 | 27.2 | 28.1 |
| Unadjusted Odds Ratio (95% CI) † | Reference | 1.08 (1.01, 1.15) | Reference | 1.05 (0.98, 1.12) |
| Adjusted Odds Ratio (95%CI) ‡ | Reference | 1.00 (0.93, 1.06) | Reference | 1.06 (0.99, 1.13) |
| Systolic blood pressure, median (IQR) | 125 (111, 141) | 125 (110, 142) | 125 (113, 138) | 125 (113, 139) |
| Diastolic blood pressure, median (IQR) | 73 (64, 84) | 74 (64, 85) | 70 (63, 78) | 70 (62, 79) |
|
| ||||
| Education < 12th grade § | N=3988 | N=3001 | N=3827 | N=2885 |
| Blood pressure ≥140/90mmHg* (%) | 38.5 | 42.2 | 27.2 | 28.9 |
| Unadjusted Odds Ratio (95% CI) † | Reference | 1.16 (1.05, 1.29) | Reference | 1.06 (0.95, 1.18) |
| Adjusted Odds Ratio (95%CI) ‡ | Reference | 1.04 (0.93, 1.16) | Reference | 1.06 (0.94, 1.19) |
| Systolic blood pressure, median (IQR) | 127 (112, 145) | 130 (112, 147) | 125 (113, 138) | 125 (113, 139) |
| Diastolic blood pressure, median (IQR) | 72 (61, 83) | 72 (61, 83) | 70 (62, 78) | 70 (62, 78) |
| Education ≥ 12th grade | N=29580 | N=6436 | N=28384 | N=6176 |
| Blood pressure ≥140/90mmHg* % | 35.3 | 39.2 | 27.5 | 28.5 |
| Unadjusted Odds Ratio (95% CI) † | Reference | 1.18 (1.11, 1.25) | Reference | 1.05 (0.99, 1.12) |
| Adjusted Odds Ratio (95%CI) ‡ | Reference | 1.05 (0.99, 1.12) | Reference | 1.03 (0.97, 1.11) |
| Systolic blood pressure, median (IQR) | 126 (111, 142) | 128 (112, 145) | 125 (113, 138) | 125 (113, 138) |
| Diastolic blood pressure, median (IQR) | 72 (62, 82) | 71 (61, 82) | 70 (62, 78) | 70 (62, 79) |
|
| ||||
| Presented to the emergency department | N=17240 | N=5751 | N=16567 | N=5551 |
| Blood pressure ≥140/90mmHg* % | 44.7 | 46.0 | 28.6 | 30.1 |
| Unadjusted Odds Ratio (95% CI) † | Reference | 1.05 (0.99, 1.12) | Reference | 1.07 (1.00, 1.15) |
| Adjusted Odds Ratio (95%CI) ‡ | Reference | 0.90 (0.84, 0.96) | Reference | 1.04 (0.97, 1.12) |
| Systolic blood pressure, median (IQR) | 132 (116, 148) | 132 (114, 150) | 125 (113, 139) | 126 (113, 139) |
| Diastolic blood pressure, median (IQR) | 75 (65, 86) | 73 (62, 85) | 70 (63, 79) | 70 (62, 78) |
*
Elevated blood pressure defined as ≥130/80 for patients with diabetes or renal disease
†
Robust standard errors used to account for patients who contributed multiple hospitalizations
‡
Logistic regression model evaluating the odds of a Blood pressure ≥140/90 mmHg (or ≥130/80 mmHg if renal or diabetes) by low health literacy status adjusted for: age, gender, race, insurance category (Medicare reference), coronary artery disease, cerebrovascular disease, congestive heart failure, transplant status and type of antihypertensive categories used (see Supplemental Table 2) with robust standard errors to account for patients who contributed multiple hospitalizations to the analyses.
§
Education level missing for 3,258 patients in first blood pressure analyses and 3,139 patients in mean blood pressure on day of hospitalization analyses.